We carried out a review of the data available to us about The Limes CHN on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Limes CHN, you can give feedback on this service.
The Limes is a residential care home that provides accommodation and personal care and support to a maximum of 76 older people and for some older people living with dementia. At the time of our inspection 51 people were living at the service.
People's experience of using this service and what we found
The provider had safeguarding systems and processes in place to keep people safe. Staff knew the risks to
people and followed the assessments to ensure they met people's needs. People felt safe and were supported by staff who knew how to protect them from avoidable harm.
Staff were recruited safely and there were enough staff to meet people's needs. Staff followed the infection control procedures the provider had in place. Risks to people's health and well-being had been assessed and monitored to ensure they were kept safe. People received their medication as prescribed.
The provider had quality assurance systems with spot and competency checks of staff completed regularly. The registered manager understood their legal responsibilities in regard to safeguarding and notifications. The provider worked with other professionals such as district nurses and GP's to ensure care needs were met.
People and their relatives told us the service was well-led. They told us the management team and staff were good. Provider feedback processes had been used to gather information about the views of people, their relatives and stakeholders about the service provision.
Staff spoke positively about working for the provider. They felt well supported and that they could talk to the management team at any time, feeling confident any concerns would be acted on promptly. They felt valued and happy in their role.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 19 April 2018).
Why we inspected
We received concerns in relation the management of safeguarding incidents. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of Safe and Well-Led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe and Well-Led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Limes Care Home on our website at www.cqc.org.uk.
Follow up
We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We had previously inspected this service on 26 and 27 November 2015. At which time the service was registered at a previous location and was known as The Limes Rest Home. Following the inspection we rated the provider ‘requires improvement’ and made a recommendation that the registered provider’s quality assurance arrangements were improved to identify any areas of concern and to ensure the home was compliant with the regulations.
At this most recent inspection we found the provider and registered manager had made the required improvements and the service is now rated as ‘Good’.
The Limes Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The Limes Care Home is registered to provide accommodation for up to 76 people who have dementia or mental health needs and caters for both younger and older adults. On the day of the inspection there were 44 people living at the home.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People told us they felt safe. Staff received training in protecting people from harm and knew how to escalate any concerns for people’s safety and well-being. Risks were assessed and managed to reduce the risk of harm and there were sufficient numbers of staff to respond to people’s care and support needs. The provider had safe recruitment practices which ensured only staff safe to work with vulnerable people were employed.
People received their medicines as prescribed and systems used to manage and store medicines were safe. People were protected from the risk of infection by a clean home environment and the provider had established systems to monitor the standards of cleanliness throughout the home. Where incidents and events took place the provider and registered manager learned from these and where appropriate implemented changes to raise standards within the home.
People needs and preferences were assessed prior to them moving into The Limes. People were supported by staff who had received an induction and training for their role and who were supported by the provider and registered manager. People received food and drink that met their nutrition and hydration needs and where people required specific dietary support, this was provided by staff. The staff team worked well with other agencies to ensure people’s holistic needs were met and referrals to external agencies about people’s health were made in a timely way.
People were asked for their consent before care was provided and where people’s rights were restricted to protect them from harm, this had been done lawfully. The home environment was well maintained and appropriate for the needs of people living at the home. Some opportunities to better meet the needs of people living with dementia had been missed due to a lack of reminiscence areas throughout the home.
People were supported by staff who were kind and caring. People were supported to make their own decisions about their daily lives and staff were aware of people’s life histories and diverse needs. Staff treated people as individuals and recognised that each person’s needs were different. People’s privacy and dignity was maintained by staff and visitors were welcomed into the home by staff who knew them.
People and relatives were involved in the assessment, planning and review of their care and support. Where people’s needs changed the care provided by staff was responsive to the changes and was reviewed and planned to reflect any additional needs. Staff had a good knowledge of people’s life histories as well as their needs and provided appropriate support that reflected people’s individual interests and preferences. A range of activities were available that took into account people’s interests and hobbies.
People knew how to make a complaint if they were unhappy about the care they received and the provider had systems in place to ensure people’s views were listened to. Complaints were investigated by the registered manager or provider and any improvements made following a complaint were communicated to the complainant as part of the provider’s response.
People, relatives and staff felt the home was well managed and a number of relatives and staff we spoke with told us they would recommend the home to others. The registered manager and provider had taken on board feedback from the last inspection and made significant improvements to the quality assurance systems used to monitor the quality of care provided. Staff felt supported by the management team and felt their views were listened to and respected. People had been asked for their views on the care they received and the provider had made changes following feedback from visitors and staff.
There was a registered manager in post who demonstrated a good understanding of the responsibilities of their role and staff described the management team as approachable and supportive.